The Addiction Research and Research Corporation (ARTC) is a 501(c)(3) not-for-profit organization operating in New York City. ARTC is certified by the New York State Office of Alcoholism and Substance Abuse Services (OASAS) and licensed as a diagnostic and treatment center (Article 28) under an operating certificate issued by the Office of Health Systems Management of the New York State Department of Health. The agency was organized in 1969 to deal with the unique problems of the minority addict. Since its inception, ARTC has grown to be one of the country’s largest opiate treatment programs now providing primary medical care and comprehensive HIV/AIDS services.
During the more than 40 years, ARTC has been committed to serving opioid addicted patients in the inner-city communities of New York. Despite the changing healthcare landscape, our mission remains unchanged. ARTC continues to address the treatment of opiate addiction and secondary chemical addiction using a comprehensive multi-modality approach. This is exemplified in the Corporation’s goals:
- Admitting for treatment, those individuals who meet regulatory agency criteria, with emphasis on outreach to the special target population historically served by ARTC – the minority, inner-city, economically disadvantaged opiate addict;
- Providing comprehensive services to the persons served within an interdisciplinary team model to promote recovery or stabilization, reduce dysfunctional symptoms, restore function and prevent additional functional impairment;
- Addressing patient needs by providing sufficient resources to implement comprehensive services that reflect the needed intensity and duration of care, as well as the patient’s strengths, needs, abilities and preferences;
- Addressing individualized patient needs by identifying long and short-term goals and providing comprehensive services on-site, or through education and referral to a network of providers that can address assessed needs, including on-going communication between providers;
- Providing services that are sensitive and relevant to the diversity of the persons served, including those with special needs; and those who have been historically underserved including women and individuals with mental and/or physical challenges;
- Providing an interdisciplinary approach to treatment that assists the persons served to be retained in treatment for as long as needed to meet or maintain optimal functioning; to achieve and maintain abstinence from non-prescribed psycho-active drugs; and, to become economically self-sufficient through a process of vocational/educational evaluation, readiness, counseling and placement and the achievement of vocational rehabilitation.
Outpatient Treatment Services
ARTC offers comprehensive outpatient services to all enrolled patients. These include a
combination of medical-specific and other psychotherapeutic services as follows.
Medical-specific services refer to those that are provided by Licensed Medical Staff to enrolled patients. These include medical screening, assessment, referral, and pharmacotherapy.
Patients addicted to heroin or other opiates receive a dosage of Methadone prescribed by the clinic physician. Taken as prescribed, Methadone is effective in allowing patients to engage in productive activities and meet specific treatment objectives that constitute rehabilitation.
ARTC’s medical staff, which consists of physicians, physician assistants, nurse practitioners, nurses and medical technicians, offers comprehensive primary health care, pharmacotherapy options, nutritional counseling and other medical services. HIV testing, pre and post-test counseling and HIV primary care services and case management are available on-site as well as other medications for the treatment of HIV/AIDS-related illnesses.
From time to time, patients will have the opportunity to participate in research projects. Such participation may include completing questionnaires, being interviewed by research staff, or participation in specific medical or behavioral interventions. Participation in research is always voluntary.
ARTC offers a variety of psycho-therapeutic services that are complementary to the medical-specific services. The frequency and intensity of these are based on each patient’s
individualized needs, as assessed by the interdisciplinary treatment (IDT) team. The clinical staff who are providing these services are expected to be fully competent to serve persons who are diagnosed with opioid dependency, as demonstrated by their ability to
implement the 12 Core Functions, as identified by the New York State Office of Alcoholism and Substance Abuse Services. Clinical Staff are also expected to be able to provide additional interventions as needed.
Core Functions Based Services
ARTC offers the following services to patients utilizing the service-based Core Functions
Screening Services are provided to all patients who seek treatment at ARTC. This consists of data collection and preliminary assessment activities that determine if the patient is appropriate and eligible for admission to ARTC.
Intake Services are also provided to all patients who are deemed to be appropriate and eligible for admission. This consists of administrative and clinical data collection and assessment activities that facilitate the patient’s admission to ARTC.
Orientation Services are offered to all patients who are newly admitted to ARTC. This consists of informational-based activities that assist the patient in understanding the structure of the program; the range of available services; how these can be accessed; the shared responsibilities of the patient and the program; and the expected treatment outcomes.
Psychosocial Assessment Services:
Patients who access treatment at ARTC are continually assessed by the clinical staff. All patients receive a full and thorough Psychosocial Assessment within their initial 30 days of
treatment. Interdisciplinary staff contributes their assessment of designated areas of the patient’s functioning. These assessments specify the strengths, needs, abilities and preferences (SNAP) of the patient, which are holistically integrated into the Interpretive Summary, with identified problems and recommendations.
Treatment Planning Services:
Treatment Planning Services are also provided on an interdisciplinarybasis. Each patient, in collaboration with members of the interdisciplinary treatment team (IDT) develops a treatment plan. The assessed SNAP, i.e. strengths, needs, abilities, and preferences are used as starting points to specify the goals and behavioral objectives. These guide the patient through treatment and will be periodically reviewed for progress and their ongoing appropriateness.
This refers to a variety of verbal and/or behavioral techniques that are used to assist patients on an individual, group, or family basis. All of ARTC’s Substance Abuse Counselors are required to participate in on-the-job training regarding Interpersonal Communication Skills and how these can be effectively used in individual and group
modalities. Substance Abuse Counselors also participate in training on Motivational Interviewing Techniques and how these can be integrated into counseling.
Counseling Services can be sub-divided as follows:
- Individual Counseling Services: Substance Abuse Counselors provide individual counseling services that focus on each patient’s impairments that are related to opioid dependency. Issues related to the addiction to alcohol, tobacco and other drugs are also addressed as appropriate.
- Group Counseling Services: Substance Abuse Counselors provide group counseling services to patients who are assessed with similar rehabilitative needs. Groups focus on a wide range of problems of daily living. Groups also utilize a range of EBPs-Evidence Based Practices including, CBT (Cognitive Behavioral Therapy), MET (Motivational Enhancement Therapy), TTM (Trans-Theoretical Model), MI (Motivational Interviewing) and REBT (Rational Emotive Behavioral Therapy), as well as incorporate standardized curricula. A designated Group Specialist also coordinates special group activities. These include ensuring that interested patients receive information on external self-help recovery resources such as Narcotics Anonymous (NA), Alcoholics Anonymous (AA), Methadone Anonymous (MA), and others.
- Family Counseling Services: The Supervisor of Behavioral Health Services may provide onsite family and collateral counseling services. This may be on an ongoing basis for those family members who are enrolled at the clinic as they meet all of the criteria for opioid dependency. Family members who are not opioid dependent may chose, with the patient’s consent to participate in periodic, scheduled family counseling. The Supervisor of Behavioral Health Services may also facilitate the referral and enrollment of non-opioid dependent family members for family counseling, to ARTC’s affiliated outpatient chemical dependency programs, or external programs.
Case Management Services:
These refer to services that seek to assist patients with daily management, advocacy, and linkages to needed resources. These resources may pertain to disease management or to economic or natural supports that can contribute to the enhancement of the patients’ lives.
Medical Case Management:
Medical Case Management (MCM) services, for all seropositive patients at ARTC, are monitored and funded through the New York State Department of Health/AIDS Institute. The MCM standards have been adapted to create a model that conforms to the case management needs of our seropositive patients and promotes the improvement of best medical outcomes, through tailored, comprehensive and individualized service plans. Comprehensive and supportive MCM is offered at each of ARTC’s seven (7) opioid treatment programs.
Crisis Intervention Services:
These services are available for those patients who may, at random, experience a significant deterioration in usual functioning, which impairs the patient’s ability to appropriately self-manage. Crisis Intervention Services may be triggered by medical/psychiatric disabilities or social disruptions that are due to traumatic, disaster or
Patient Education/ Psycho-educational Services:
All enrolled patients are eligible for Patient Education/ Psycho-educational Services.
The Substance Abuse Counselors, Supervisor of Behavioral Health Services and other clinical staff provide these services. The focus is on areas of patient functioning where there are assessed needs for education in order to develop understanding, promote exploration, and enhance motivation for taking action. Psycho-education thus addresses issues such as how various chemicals of addiction impact on the body; the signs and symptoms of relapse; adequate daily nutrition; entitlement information; job readiness preparation; and adult basic remedial education. Patient Education/Psycho-educational Services are meant to facilitate self-efficacy towards attaining healthy behaviors.
Through established linkage agreements referrals are made to other programs that provide services that are not available at ARTC to augment our existing services. For example, patients can receive assistance with obtaining housing, and other medical and mental health services such as inpatient detoxification and specialty referrals at secondary and tertiary centers. ARTC also has staff who are specially trained to provide assistance with advocacy and public benefits. All referrals are made with the consent of our patients based on need, geographic locations and preference if requested.
Report and Record Keeping Services:
ARTC adheres to all applicable federal and state laws, regulatory guidelines, and professional/ethical codes governing methadone treatment and appropriate patient care. As an integral part of this, ARTC’s staff are expected to ensure that all patient documentation is completed contemporaneously, thoroughly and legibly. Documentation must also be available, as appropriate for disclosure, as consistent with all applicable laws. Quality assurance activities will assist in monitoring this service.
Interdisciplinary consultation is an integral part of service provision to enrolled patients. Clinical staff will, as appropriate, and with the patients’ authorization seeks external consultation as needed to address identified concerns with qualified professionals.
Additional Psychotherapeutic Services
Additionally to the Core Functions Based Services, the following specific services are also
available to all eligible patients:
Behavioral Health Services:
The Supervisor of Behavioral Health Services (Psychologist or Licensed Social Worker) provides initial and ongoing mental health evaluations, psychotherapy, crisis intervention, family therapy, individual and group psychotherapy, and referrals to out-patient and in-patient mental health agencies when indicated. The identification of secondary mental health diagnoses affords the Inter-Disciplinary Treatment Team the opportunity to address needs and provide interventions appropriate to co-morbidity.
The Vocational Specialist assesses patients’ vocational strengths and aptitudes, and helps the patient to formulate career goals. Patients also receive assistance with referrals to appropriate training and vocational programs; and job development and placement opportunities. The Vocational Specialist also acts as a liaison between the patient and various city and state agencies to help facilitate the provision of services.
The Educational Coordinator/Specialist provides direct educational services to identified patients. Patients are eligible to receive testing and educational evaluation; remedial reading, math and ESL tutoring; and GED preparation. Patients may also receive assistance with referrals to community educational and vocational training programs.
The Supervisor of Behavioral Health Services at each clinic is available to assist with the identification of the special treatment needs of women. This staff coordinates the development of special projects to meet women’s needs, including women’s counseling groups that address personal, work and family issues; and films and featured speakers. Assistance with arranging day care services may also be provided.
Transition/Discharge Planning Services:
All patients who are enrolled at ARTC are assisted with developing a Transition/Discharge Plan. This addresses the patient’s individual timeframe for attaining transition milestones, including completing and/or moving to a less restrictive level of care. Necessary supports are also assessed for each patient.
Those patients who voluntarily request medically supervised withdrawal and are abstinent may chose to continue to receive counseling and other supportive services from ARTC. These can be accessed as part of Aftercare Services.
Bilingual/Culturally Competent/Diversity-Based Services:
ARTC makes every effort to recruit and hire qualified staff who are reflective of the patient populations served. Bilingual Spanish services are provided at all clinics. If a need is assessed for services in other languages or medium, these will be accessed through consultation and/or referral to appropriate external resources. On an annual basis, staff receives training updates around multicultural/culturally competent and diversity-based issues, including that pertaining to gender, age, ethnicity, disability, and similar
ARTC also has in place a structured process for ensuring that patients who present with special needs, i.e. needs related to HIV/AIDS; medical fragility; the criminal justice system; and, those with co-morbid mental health issues are assessed and treated. Through the coordination of the Inter-Disciplinary Treatment Team, these persons may be treated onsite, with any specific interventions being identified in their plan of care.
In the event that ARTC is unable to fully meet the needs of patients with special concerns, referral agreements are in place to address these needs. Additionally, those persons who
are diagnosed with secondary chemical dependency are referred to ARTC’s REACH (Recovery, Education, Advocacy, and Change for Health) and, to the affiliated Urban Resource Institute’s, Marguerite T. Saunders Urban Center for Alcoholism and Addiction Services (MS-UCAS), or other external intensive chemical dependency programs for concurrent treatment. Coordination of services for all external referrals will also be maintained. Note that REACH and MS-UCAS offer specialized mental health/psychiatric services, which are needed by some of the persons served who have co-occurring disorders.
As part of ARTC’s holistic approach to treatment, staff representing the different disciplines work collaboratively to provide continuing, individualized treatment for each patient. As part of the treatment planning process, Long Range Goals, Short Range Goals and behaviorally defined Objectives are developed with each patient’s input. These identify outcome expectations, time frames, and targeted behavioral interventions to address the individual needs of each person served. Ongoing documentation of patient’s progress is assessed and maintained in each patient’s record through the Progress Notes, Case Conferences, Treatment Plans, and Discharge Plans.
Location of services:
ARTC has seven Opiate Treatment Programs located in Brooklyn and Manhattan. These inner cities communities of New York City are accessible by public transportation.
Hours of Operations:
The hours of operation vary from clinic to clinic and were established based on the needs of the population. Patients who are employed and those with special needs are
accommodated. In addition, ARTC has a physician-on-call 24/7 who is available to institutions, hospitals and patients should they need care or information after clinic hours.